[A patient with rabies in The Netherlands]

A 49-year-old Moroccan man was admitted to hospital with chest pain and dyspnoea. The next day he had paresis of the left arm and because of respiratory arrest he was transferred to the intensive care unit. A fast-progressive neurological illness developed with flaccid tetraparesis, areflexia and a lowered level of consciousness. He died 11 days after admission. The strong clinical suspicion of rabies was confirmed by very high antibody titres in serum and CSF and by positive immunofluorescence in mice inoculated with the patient's CSF. This was the first case of rabies in the Netherlands since 1963.